高度近视患者白内障超声乳化术对泪膜的影响

目的:探讨高度近视患者超声乳化吸除术后早期泪膜的改变。方法:选择59例(70眼)行白内障超声乳化吸除术的高度近视患者(屈光度为-6.00D~-17.25D),观察分析其术前、术后1d、1wk、1,3mo的主观感觉,泪膜破裂时间(break-up time,BUT),基础泪液分泌试验(Schimer试验)和角膜荧光素试验结果。比较各项结果在术后不同时间与术前的差异。结果:与术前相比,患者术后1d,1wk,不适主诉增加,术眼BUT较术前缩短,差异具有显著性(P<0.05),术后3mo接近术前水平,差异无显著性。术后1d、1wk角膜荧光素着色点明显增多,差异具有显著性(P<0.05)。术后3mo接近术前水平,无显著差异。术后1d泪液分泌量增多,差异具有显著性(P<0.05)。术后1wk,1,3mo接近术前水平,差异无显著性。结论:高度近视患者超声乳化吸除术后早期即可出现泪膜异常改变,尤其表现为泪膜稳定性下降,因而,此类人群为干眼的易患人群。

Early changes of tear film after phecoemulsification for cataract in high myopia

AIM:To study the early changes of tear film after phacoemulsification for cataract in high myopia. METHODS:Fifty-nine patients(70 eyes)with high myopia cataract(diopter-6.00D~-17.25D)who had undergone phacoemulsification were randomly selected.The evaluation included subjective complaints of dry eye,tear break-up time(BUT),SchirmerⅠtest and corneal fluorescein staining were analyzed before surgery and 1 day,1 week,1 and 3 months postoperatively. RESULTS:Subjective complaints of dry eye increased and the mean tear break-up time was significantly re-duced(P<0.05)on day 1 and 1 week after operation.However,all values recovered to preoperative levels by the time of the third month follow-up visit.Corneal fluorescein staining score increased greatly when mea-sured at day 1 and 1 week visit(P<0.05),but had returned to preoperative values at the third month visit.The mean SIt value increased significantly on day 1 postoperatively(P<0.05),and returned to the preo-perative value after 1 week. CONCLUSION:During the early stage after ph-acoemulsification,tear film in high myopia may present abnormal changes,mainly in tear stability.They tend to get dry eyes.